Victorian Jazz Club Inc.

MEMBERSHIP RENEWAL/APPLICATION for 2018

Upon acceptance of the application, membership will be current until 31 st December 2018 1/We agree to support the purposes of the Club (namely, the enjoyment of Jazz Music) and comply with Club Rules

Either: Complete this PDF Fillable Form and email to membership@vjc.org.au (signature not required if emailing)

(Note: some browsers don’t support PDF Fillable Forms)

Or just print off, fill out by hand and post or scan and email to membership@vjc.org.au

Membership Number

Firstname Surname Musician

1

2

3

Address 1 State

Address 2 Postcode

City

Phone (H) Phone (M)

email

IF ENTERING BY HAND, PLEASE PRINT EMAIL ADDRESS CLEARLY

Family or Single member benefits include JAZZLINE twice per year, and JAZZBEAT monthly

Please indicate the appropriate Membership category, ONE of the following

Family membership

$55Single membership

$45Subscribermembership

$40

Cheques/money orders should be made payable to the Victorian Jazz Club Inc

Or:

can be direct debited to BSB 633000the following account: A/c No. 154805675

Account Victorian Jazz Club “Club” Account

Don’t forget to add your name or number otherwise we won’t know who you are

email form to: membership@vjc.org.au

or post form to: Victorian Jazz Club Inc.

Box 1538 Moorabbin B.C. Vic 3189Form available at www.vjc.org.au

Signature:………………………………………………………………….…….(Not required if emailing form)

Membership Application Form Online - 2018 V1.odt